Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $83.18 / $83.18	Facility	26	$74.13	$83.18	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $281.84 / $501.19	Professional		$173.78	$281.84	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $69.18 / $165.96	Professional	26	$54.95	$69.18	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $199.53 / $338.84	Professional	TC	$114.82	$199.53	$338.84
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	26	$346.74	$346.74	$346.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $316.23 / $436.52	Professional		$302.00	$316.23	$436.52
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $109.65 / $151.36	Professional	26	$93.33	$109.65	$151.36
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $208.93 / $288.40	Professional	TC	$194.98	$208.93	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $275.42 / $457.09	Professional		$144.54	$275.42	$457.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $67.61 / $123.03	Professional	26	$47.86	$67.61	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $199.53 / $331.13	Professional	TC	$95.50	$199.53	$331.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $912.01 / $1,023.29	Professional		$912.01	$912.01	$1,023.29
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $467.74 / $467.74 / $467.74	Professional	26	$467.74	$467.74	$467.74
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $457.09 / $562.34	Professional	TC	$457.09	$457.09	$562.34
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $83.18 / $83.18	Facility	26	$74.13	$83.18	$83.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $338.84 / $501.19	Professional		$239.88	$338.84	$501.19
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $112.20 / $134.90	Professional	26	$60.26	$112.20	$134.90
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $223.87 / $354.81	Professional	TC	$162.18	$223.87	$354.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $114.82	Professional		$32.36	$33.11	$114.82
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	26	$346.74	$346.74	$346.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $354.81 / $478.63	Professional		$263.03	$354.81	$478.63
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $114.82 / $147.91	Professional	26	$95.50	$114.82	$147.91
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $245.47 / $371.54	Professional	TC	$165.96	$245.47	$371.54
Select Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $162.18 / $575.44	Professional		$158.49	$162.18	$575.44
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $53.70 / $125.89	Professional	26	$53.70	$53.70	$125.89
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $117.49 / $457.09	Professional	TC	$104.71	$117.49	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $251.19 / $537.03	Professional		$169.82	$251.19	$537.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $63.10 / $125.89	Professional	26	$50.12	$63.10	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $199.53 / $416.87	Professional	TC	$117.49	$199.53	$416.87